ABSTRACT
INTRODUCTION: A 16 years old girl presented with gradual foot pain after running 2 kilometers. Conservative treatment that consisted of rest and high dose of analgesia had no effect. An MRI scan revealed a partial tear of the abductor hallucis muscle with diffuse edema in the compartment. Under general anesthesia compartmental pressure was measured. The involved compartment's pressure was 130 mm/hg while the contralateral foot measured 10 mm/hg. Immediate fasciotomy was performed with instant pain relief. No analgesics were needed following surgery. Compartment syndrome usually develops following trauma. In unusual cases the syndrome can appear due to other causes, such as muscle tear and present with different clinical signs and rates of presentation. Exertional compartment syndrome presents in the pediatric population, but can rarely present in the foot. High clinical suspicion and awareness can help the diagnosis in challenging cases.
Subject(s)
Compartment Syndromes , Running , Adolescent , Child , Compartment Syndromes/diagnosis , Compartment Syndromes/etiology , Compartment Syndromes/therapy , Fasciotomy , Female , Foot , Humans , Pain/diagnosis , Pain/etiologyABSTRACT
We describe a 1-year and 8-month-old girl who underwent closed reduction and percutaneous pinning by Kirschner wires of a fully displaced supracondylar humeral fracture. At follow-up, self-mutilation of the fifth finger was noticed. A nerve conduction study confirmed ulnar nerve neurapraxia, which allowed the patient to bite her fifth finger painlessly. CONCLUSION: Although self-mutilation after closed reduction and percutaneous pinning of supracondylar fractures was not previously described, and is probably very rare, a high index of suspicion and close follow-up is needed in infants in this setting.
